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Q: While at sea recently, I suffered a TIA (transient...

July 13, 2000|By Dr. Allen Douma.

Q: While at sea recently, I suffered a TIA (transient ischemic attack, or mini-stroke). Now I am very tired, but the left side of my face has returned to normal. What should I do to prevent any recurrence?

A: It sounds like you've recovered (I'm not sure your being tired has anything to do with the recent TIA), which is good news. But you should know that TIAs may indeed recur, and, more important, you may be at higher risk of having a stroke from which you won't fully recover.

Transient ischemic attacks are usually caused by a blood clot (thrombus) breaking off inside the heart or an artery leading to the brain. This clot (now called an embolus) travels through the network of arteries until it wedges into a smaller branch. There it temporarily causes blockage of blood flow (ischemia).

The symptoms of a TIA depend on which part of the brain had a blood flow blockage. However, the more common symptoms, which occur on only one side of the body, include weakness or heaviness of an arm, leg or side of the face; numbness or tingling; and difficulty in speaking or seeing. The symptoms vary a lot from person to person, but they tend to be similar for a given individual from one attack to the next.

The symptoms almost always go away within a couple of hours and often do so within a few minutes. By definition of a TIA, all of the symptoms must have gone away within 24 hours. If you had numbness on the left side of your face or any other such symptom that lasted for more than a day or two, you may have had more than just a TIA.

It's important, especially after the first symptoms are seen, to determine if it's really a TIA.

It's also important to locate the source of the emboli: the heart, the aorta, the carotid arteries that carry blood into the brain, or the smaller arteries that distribute blood within the regions of the brain. I hope you followed up with a health care provider after the cruise to find out.

Treatment is aimed at preventing more TIAs, but even more important, preventing a more serious stroke.

One of the most effective ways to reduce the risk of stroke is to take one regular aspirin (325 milligrams) a day. It may be slightly better to take more, but the risk of intestinal bleeding increases as the dose goes up.

Depending on where the clots are forming and how much blockage there is at the clot sites, surgery may or may not be recommended.

While blood clots are an important cause of TIAs, they are not the only cause. At times, certain heart diseases or abnormalities and abnormalities of blood cells and blood vessels can also cause TIAs.

The first step for you is see your doctor to identify the cause of your TIA, then develop a treatment plan.